H1N1 influenza circulating in India cause for conc

H1N1 influenza circulating in India cause for concern

March 11, 2015 | By Michael Johnsen

CAMBRIDGE, Mass. — Since December, an outbreak of swine flu in India has killed more than 1,200 people, and a new MIT study suggests that the strain has acquired mutations that make it more dangerous than previously circulating strains of H1N1 influenza.

The findings, which appear in the March 11 issue of Cell Host & Microbe, contradict previous reports from Indian health officials that the strain has not changed from the version of H1N1 that emerged in 2009 and has been circulating around the world ever since.

With very little scientific data available about the new strain, the MIT researchers stress the need for better surveillance to track the outbreak and to help scientists to determine how to respond to this influenza variant.

"We're really caught between a rock and a hard place, with little information and a lot of misinformation," stated Ram Sasisekharan, the Alfred H. Caspary Professor of Biological Engineering at MIT and the paper's senior author. "When you do real-time surveillance, get organized, and deposit these sequences, then you can come up with a better strategy to respond to the virus."


"When you do real-time surveillance, get organized, and deposit these sequences, then you can come up with a better strategy to respond to the virus.”
In the past two years, genetic sequence information of the flu-virus protein hemagglutinin from only two influenza strains from India has been deposited into publicly available influenza databases, making it difficult to determine exactly which strain is causing the new outbreak, and how it differs from previous strains. However, those two strains yielded enough information to warrant concern, says Sasisekharan, who is also a member of MIT's Koch Institute for Integrative Cancer Research.

He and Kannan Tharakaraman, a research scientist in MIT's Department of Biological Engineering, compared the genetic sequences of those two strains to the strain of H1N1 that emerged in 2009 and killed more than 18,000 people worldwide between 2009 and 2012.

The researchers found that the recent Indian strains carry new mutations in the hemagglutinin protein that are known to make the virus more virulent. Hemagglutinin binds to glycan receptors found on the surface of respiratory cells, and the strength of that binding determines how effectively the virus can infect those cells.

One of the new mutations is in an amino acid position called D225, which has been linked with increased disease severity. Another mutation, in the T200A position, allows hemagglutinin to bind more strongly to glycan receptors, making the virus more infectious.

Sasisekharan noted that more surveillance is needed to determine whether these mutations are present in the strain that is causing the current outbreak, which is most prevalent in the Indian states of Gujarat and Rajasthan and has infected more than 20,000 people so far.

"The point we're trying to make is that there is a real need for aggressive surveillance to ensure that the anxiety and hysteria are brought down and people are able to focus on what they really need to worry about," Sasisekharan said. "We need to understand the pathology and the severity, rather than simply relying on anecdotal information."

Learning more about the new strains could help public health officials to determine which drugs might be effective and to design new vaccines for the next flu season, which will likely include strains that are now circulating.

"The goal is to get a clearer picture of the strains that are circulating and therefore anticipate the right kind of a vaccine strategy for 2016," Sasisekharan said.



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Public Release: 11-Mar-2015 Analysis suggests a more virulent swine flu virus in the Indian subcontinent

Cell Press

A flu outbreak in India that has claimed over 1200 lives may not be identical to the 2009 North American strain, as recently reported in India. A comparative analysis conducted by scientists at the Massachusetts Institute of Technology (MIT) shows that the flu virus in India seems to have acquired mutations that could spread more readily and therefore requires deeper studies. As flu season in India winds down, the researchers call on officials to increase surveillance of this and future flu outbreaks and rethink vaccination strategies to account for potential new viruses.

The MIT analysis, which compared viral proteins important for virulence and transmissibility in the 2009 and 2014 flu epidemics, was conducted by professor Ram Sasisekharan, PhD, at the Koch Institute for Integrative Cancer Research, and his research scientist colleague Kannan Tharakaraman, PhD. It appears in the March 11 issue of the journal Cell Host & Microbe.

"It has been extensively reported in India that a virus similar to A/California/07/2009 is responsible for the current outbreak," Sasisekharan says. "Examination of the Indian H1N1 flu viruses that circulated in 2014 shows amino acid mutations that make them distinct (in terms of receptor binding, virulence, and antigenic drift) from the A/California/07/2009 virus."

"It is widely believed that the current H1N1 flu vaccine is still effective for the most part," he adds. "Effectiveness of the current H1N1 flu vaccine is debatable, and there have been calls for updating the vaccine. The Indian H1N1 viruses that circulated in 2014 are different compared to the 2009 vaccine strain A/California/07/2009."

A lack of rigorous scientific information is resulting in conflicting reports on the 2014 Indian flu outbreak. The authors of the current study also note that since 2012, the number of viral sequences submitted for public analysis from India has been limited relative to the population that is susceptible to being infected by the virus. Adequate monitoring of influenza viruses in animal populations, which enables real-time surveillance in humans, has also been limited.

"In many ways the handling of the H7N9 outbreak in 2013 represents a scientifically robust way in which to handle such an infectious disease outbreak," Sasisekharan says. "Sequences of the virus were rapidly made available to the scientific community, the phenotype of the virus was measured in controlled studies, and the results were disseminated in scientific publications. At the same time, vaccine strategies were developed."

"While there certainly is a delay between the advent of such an outbreak and the availability of vaccines, I believe that the robust scientific discussion that occurred in 2013 facilitated an understanding of the virus and a discussion of appropriate countermeasures to stop the virus from spreading," he says. "I believe that this model should be built upon, enabling information to cross borders."

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This work was funded in part by National Institutes of Health Merit Award, a National Institute of Allergy and Infectious Diseases Award, the National Research Foundation-supported Interdisciplinary Research group in Infectious Diseases of SMART (Singapore MIT alliance for Research and Technology), and the Skolkovo Foundation-supported Infectious Diseases Center at MIT.

Cell Host & Microbe, Tharakaraman, K. and Sasisekharan, R.: "Influenza Surveillance: 2014-2015 H1N1 'Swine'-Derived Influenza Viruses from India"

Cell Host & Microbe, published by Cell Press, is a monthly journal that publishes novel findings and translational studies related to microbes (which include bacteria, fungi, parasites, and viruses). The unifying theme is the integrated study of microbes in conjunction and communication with each other, their host, and the cellular environment they inhabit. For more information, please visit http://www.cell.com/cell-host-microbe. To receive media alerts for Cell Host & Microbe or other Cell Press journals, contact press@cell.com.



http://www.eurekalert.org/pub_releases/2015-03/cp-asa030515.php

    India is now beginning an attempt at coverup of the dangers of this new H1N1 strain.  Also we are at risk for another vaccine fiasco next winter if this strain spreads and, if as my friends at CIDRAP suspect, it is also vaccine resistant.  This issue needs to be addressed NOW by CDC wnd FDA while there is still time to create an effective vaccine.  Fat chance, mark my words.

By: Express News Service | Lucknow | Published on:March 15, 2015 3:03 am